Mamun Mohammed A, Al-Mamun Firoj, Roy Nitai, Raquib Ahsan, Kaggwa Mark Mohan, ALmerab Moneerah Mohammad, Gozal David, Hossain Md Shakhaoat
Air Quality, Climate Change and Health (ACH) Lab, Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh.
Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Dhaka, Bangladesh.
Int Arch Occup Environ Health. 2025 Jan;98(1):33-57. doi: 10.1007/s00420-024-02112-9. Epub 2024 Dec 15.
The rising prevalence of ASD has prompted extensive research into potential environmental risk factors, with air pollution particularly emerging as a major concern. A systematic review and meta-analysis on the effect of air pollutants and time of exposure (particularly, PM, PM, NO, and O) and the risk of ASD was therefore performed.
Following PRISMA guidelines and PROSPERO registration (Ref: CRD42023464592), a thorough literature search was conducted across multiple databases, including Scopus, PubMed/MEDLINE, Embase, PsycINFO, Web of Science, and Cochrane Library. The analysis included 27 studies encompassing 369,460 participants, 47,973 of whom were diagnosed with ASD.
Preconception exposure to air pollutants showed a protective trend for PM, PM, and O with a 10%, 5%, and 19% reduced risk of ASD, whereas NO had a 28% higher likelihood of ASD. During gestation, PM exposure increased ASD risk by 15%, with 13% and 9%, 25% and 7%, and 25% and 10% increases in ASD risk with PM and NO for the first, second, and third trimesters, respectively. In the first year of life, 20%, 8%, 33%, and 14% increases in risk were found for PM, PM, NO, and O, respectively, while such risk estimates increased to 179%, 60%, 12%, and 179% for the second year of life.
In this meta-analysis, the relationships between air pollutants and ASD risk revealed significant associations, particularly for PM and NO. Exposure during preconception exhibited a protective trend, while postnatal exposure, particularly during the second year of life uncovered substantially higher ASD risk.
自闭症谱系障碍（ASD）患病率的上升促使人们对潜在的环境风险因素进行广泛研究，空气污染尤其成为一个主要关注点。因此，我们对空气污染物及其暴露时间（特别是细颗粒物、粗颗粒物、氮氧化物和臭氧）与ASD风险之间的关系进行了系统综述和荟萃分析。
遵循PRISMA指南和PROSPERO注册要求（参考文献：CRD42023464592），我们在多个数据库中进行了全面的文献检索，包括Scopus、PubMed/MEDLINE、Embase、PsycINFO、Web of Science和Cochrane图书馆。该分析纳入了27项研究，涉及369,460名参与者，其中47,973人被诊断为ASD。
孕前暴露于空气污染物中，细颗粒物、粗颗粒物和臭氧显示出保护趋势，ASD风险分别降低了10%、5%和19%，而氮氧化物导致ASD的可能性高出28%。在孕期，暴露于细颗粒物会使ASD风险增加15%，在孕早期、中期和晚期，暴露于粗颗粒物和氮氧化物分别使ASD风险增加13%和9%、25%和7%、25%和10%。在生命的第一年，暴露于细颗粒物、粗颗粒物、氮氧化物和臭氧的风险分别增加了20%、8%、33%和14%，而在生命的第二年，这些风险估计分别增至179%、60%、12%和179%。
在这项荟萃分析中，空气污染物与ASD风险之间的关系显示出显著关联，尤其是细颗粒物和氮氧化物。孕前暴露呈现出保护趋势，而出生后暴露，特别是在生命的第二年，发现ASD风险大幅升高。
